Nicholas Wayne Blackwell, RPH. PHARM. D.

Primary specialty

Ambulatory Care PharmacistTaxonomy code 1835P2201X

License

58974 Issued in TX

Practice address

400 W 2ND St
Hearne, TX 77859-2566

Phone

(979) 492-2404

Fax

(979) 279-3374

NPI assigned

Sep 16, 2020

Last updated

Sep 16, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1600214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1689280505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W 2ND ST",
            "city": "HEARNE",
            "state": "TX",
            "postal_code": "778592566",
            "telephone_number": "979-492-2404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W 2ND ST",
            "city": "HEARNE",
            "state": "TX",
            "postal_code": "778592566",
            "telephone_number": "979-492-2404",
            "fax_number": "979-279-3374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKWELL",
        "first_name": "NICHOLAS",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "RPH. PHARM. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-16",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P2201X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "TX",
            "license": "58974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ambulatory Care Pharmacist in Hearne, TX
• Providers in Hearne, TX by specialty
• Ambulatory Care Pharmacist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.